不同炎症反应在脑梗死与短暂性脑缺血发作患者中表达及意义研究

目的探讨不同炎症因子在脑梗死与短暂性脑缺血发作患者的表达情况。方法选取64例短暂性脑缺血发作患者(TIA组)、58例脑梗死患者(CI组)以及50例健康人员(NC组),分析并统计3组受试对象炎症因子表达情况。结果 CI组MMP-9(83.14±9.27)μg/L、NF-κB(36.88±6.27)%、IL-33(71.63±4.83)ng/m L及hs-CRP(12.57±1.29)mg/L,TIA组分别为(29.17±4.54)μg/L、NF-κB(31.20±5.97)%、IL-33(104.59±8.27)ng/m L及hs-CRP(6.23±1.04)mg/L,两组间比较差异具有统计学意义(P=0.026、P=0.032、P=0.025和P=0.009)。Logistic回归分析显示,TC、MMP-9、IL-33及hs-CRP为CI的独立危险因素。TC、hs-CRP为TIA的独立危险因素。MMP-9+IL-33+hs-CRP预测CI发生的AUC为0.859(95%CI:0.751~0.911),显著高于MMP-9(AUC为0.711,95%CI:0.649~0.824)、IL-33(AUC为0.698,95%CI:0.659~0.855)和hs-CRP(AUC为0.705,95%CI:0.671~0.848)的诊断效能(Z=9.267、11.553和10.234,均P=0.000)。结论脑梗死、短暂性脑缺血发作患者存在炎症因子表达差异,MMP-9、IL-33及hsCRP联合检测对CI具有较高的诊断价值。

Expression of inflammatory factors in patients with cerebral infarction or transient ischemic attack and related clinical significance

Objective To investigate the expression of inflammatory factors in patients with cerebral infarction or transient ischemic attack.Methods A total of 64 patients with transient ischemic attack (TIA group),58 patients with cerebral infarction (CI group),and 50 healthy persons (NC group) were enrolled,and the expression of inflammatory factors was measured for all groups.Results There were significant differences between the CI group and the TIA group in matrix metallopeptidase-9 (MMP-9) (83.14 ±9.27 μg/L vs 29.17 ±4.54 μg/L,P =0.026),nuclear factor-kappa B (36.88％ ±6.27％ vs 31.20％ ±5.97％,P=0.032),interleukin-33 (IL-33) (71.63 ± 4.83 ng/ml vs 104.59 ± 8.27 ng/ml,P =0.025),and high-sensitivity C-reactive protein (hs-CRP)(12.57 ± 1.29 mg/L vs 6.23 ± 1.04 mg/L,P =0.009).The logistic regression analysis showed that total cholesterol (TC),MMP-9,IL-33,and hs-CRP were independent risk factors for CI,and TC and hs-CRP were independent risk factors for TIA.The area under the R0C curve (AUC) of MMP-9 + IL-33 +hs-CRP to predict CI was 0.859 (95％ confidence interval CI] 0.751-0.911),which was significantly higher than that of MMP-9 (AUC =0.711,95 ％ CI 0.649-0.824,Z =9.267,P =0.000),IL-33 (AUC =0.698,95％ CI0.659-0.855,Z=11.553,P=0.000),orhs-CRP (AUC=0.705,95％ CI0.671-0.848,Z=10.234,P=0.000).Conclusions Patients with cerebral infarction or transient ischemic attack have significant differences in the expression of inflammatory factors,and a combined measurement of MMP-9,IL-33,and hs-CRP has a high diagnostic value for CI.